Advertisement

Utilisation of specialist sonographers for head and neck ultrasound fine-needle aspiration cytology can help shorten waiting lists and improve efficiency of the service

Published:October 20, 2022DOI:https://doi.org/10.1016/j.bjoms.2022.10.006

      Abstract

      Head and neck ultrasonography with fine-needle aspiration cytology (FNAC) is recommended by the National Institute for Health and Care Excellence (NICE) and the British Association of Head and Neck Oncologists (BAHNO) for investigating neck masses. Finite specialist radiologists and increased demands on services have increased waiting lists and breached targets. Many patients are on a two-week cancer pathway and accurate investigation cannot be delayed. The implementation of a sonographer trained in neck ultrasound-guided FNAC was analysed together with its impact on the service. Over a 21-month period we have demonstrated a fall in waiting lists from 310 to 28 patients, without compromise to diagnostic accuracy. Additionally, a cost-saving of £60,000 was made. Improvements in efficiency and waiting lists can be achieved through targeted specialist training for allied health professionals, liberating specialists for other duties.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to British Journal of Oral and Maxillofacial Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. National Institute for Clinical Excellence. Guidance on cancer services: improving outcomes in head and neck cancers - the manual. National Institute for Clinical Excellence, 2004. Available from URL: https://www.nice.org.uk/guidance/csg6/resources/improving-outcomes-in-head-and-neck-cancers-update-pdf-773377597 (last accessed 25 October 2022).

        • Schache A.
        • Kerawala C.
        • Ahmed O.
        • et al.
        British Association of Head and Neck Oncologists (BAHNO) standards 2020.
        J Oral Pathol Med. 2021; 50: 262-273https://doi.org/10.1111/jop.13161
        • Li J.
        • Wang Q.
        • Wang L.
        • et al.
        Diagnostic value of fine-needle aspiration combined with ultrasound for thyroid cancer.
        Oncol Lett. 2019; 18: 2316-2321https://doi.org/10.3892/ol.2019.10584
        • Brennan P.A.
        • Davies B.
        • Poller D.
        • et al.
        Fine needle aspiration cytology (FNAC) of salivary gland tumours: repeat aspiration provides further information in cases with an unclear initial cytological diagnosis.
        Br J Oral Maxillofac Surg. 2010; 48: 26-29https://doi.org/10.1016/j.bjoms.2008.12.014
        • Sandhya K.N.
        • Girija K.L.
        • Venugopal M.
        • et al.
        Cervical lymph node evaluation in oral squamous cell carcinoma patients using ultrasound-guided fine-needle aspiration cytology - a descriptive diagnostic evaluation study in a tertiary care center.
        Contemp Clin Dent. 2020; 11: 256-260https://doi.org/10.4103/ccd.ccd_444_19
        • Mitchell O.R.
        • Dave R.
        • Bekker J.
        • et al.
        Supraclavicular lymphadenopathy following COVID-19 vaccination: an increasing presentation to the two-week wait neck lump clinic?.
        Br J Oral Maxillofac Surg. 2021; 59: 384-385https://doi.org/10.1016/j.bjoms.2021.02.002
      2. Royal College of Radiologists. Specialist training portfolio: Kaizen. Available from URL: https://www.rcr.ac.uk/clinical-radiology/specialty-training/curriculum/kaizen (last accessed 27 October 2022).

      3. Royal College of Radiologists. Ultrasound guided fine needle aspiration (FNA) of thyroid nodules. Available from URL: https://www.rcr.ac.uk/audit/ultrasound-guided-fine-needle-aspiration-fna-thyroid-nodules (last accessed 27 October 2022).